Temporal Patterns of Cervical Cancer Screening Among Danish Women 55 Years and Older Diagnosed With Cervical Cancer

The aim of the study was to describe the screening history in postmenopausal women diagnosed with cervical cancer during 1990-2013 by age and screening period.

This hospital-based cohort study included women 55 years and older diagnosed with cervical cancer at Aarhus University Hospital, Denmark, during 1990-2013. Information on their previous history of cervical cancer screening was obtained from the Danish Pathology Databank.

Overall, 47.0% (95% CI = 42.6-51.4) had no record of screening before their cervical cancer diagnosis. This proportion declined over calendar time from 69.8% (95% CI = 61.4-77.3) in 1990-1994 to 20.0% (95% CI = 12.7-29.2) in 2010-2013 and increased by age from 22.5% (95% CI = 14.6-32.0) in women aged 55 to 59 years to 63.2% (95% CI = 49.3-75.6) in women 80 years and older. Cases living in the organized screening era (i.e., birth cohorts 1943-1960) were more likely to have a record of screening than women in the preorganized screening era (i.e., birth cohorts 1901-1942) (p < .001). Of all cases, 17.7% (n = 91) had a record of screening within 5 years of diagnosis and the proportion was highest in the most recent periods and in women aged 55 to 64 years. Of cases with a record of screening within 5 years, 84.6% (95% CI = 14.5-21.2) had a normal cytology result, whereas only 8.8% (95% CI = 2.9-14.7) had high-grade squamous intraepithelial lesion or worse.

Cervical cancer in older women may partly be attributed to a lack of screening or due to a failure in screening. However, older women were in general less screened because screening was unavailable.